Abstract
Spine surgery in the upper thoracic and cervicothoracic region remains challenging due to difficult radiographic visualization and limited surgical accessibility. Although surgical strategies for treatment of severe deformities in this region might improve pain and disability, they remain complex and lack standardization. In particular for corpectomies and vertebral column reconstruction, approaches may be anterior, posterior or combined. Further, a variety of soft tissue releases and osteotomies ranging from simple facet release (Ponte or Smith Peterson Osteotomies) to vertebral column resection (VCR) may be applied for decompression and deformity correction. Additional variability exists in the use of an increasing array for anterior and posterior instrumentation that require experience and knowledge of 360-degree (360°) approaches, in addition to the number of vertebral levels that require instrumentation to ensure biomechanical stability. Against this background, the present chapter outlines surgical approaches to the upper thoracic and cervicothoracic region, recommended imaging as well as pitfalls that may be encountered when treating spinal instabilities in this region. Specifically, the aim of the presented cases is to outline:
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Typical indications for corpectomies with vertebral body replacement
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Pre-, intra- and postoperative imaging
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Selection of anterior versus posterior versus combined approaches
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Hecht, N., Czabanka, M., Vajkoczy, P. (2019). Corpectomies and Osteotomies in the Upper Thoracic Spine and Cervicothoracic Region. In: Meyer, B., Rauschmann, M. (eds) Spine Surgery. Springer, Cham. https://doi.org/10.1007/978-3-319-98875-7_52
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DOI: https://doi.org/10.1007/978-3-319-98875-7_52
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